Steinbeck G, Lüderitz B, Andresen D
Medizinische Klinik I, Universität München, F.R.G.
Eur Heart J. 1989 Sep;10 Suppl E:61-5. doi: 10.1093/eurheartj/10.suppl_e.61.
Pioneering electrophysiological studies in the 1970s by Wellens and Josephson showed that in the majority of patients who have survived an episode of sustained ventricular tachycardia, the arrhythmia can be initiated and terminated by programmed electrical stimulation in the catheterization laboratory. Later work demonstrated that this method can also be applied to patients who have survived an episode of cardiac arrest due to ventricular fibrillation, not associated with acute myocardial infarction. As a consequence, serial electrophysiologic testing can be recommended to assess the efficacy of antiarrhythmic agents for the guidance of long-term treatment of these patients. This report focuses on some aspects of this method such as the recommended indications at present, differences in the electrophysiologic protocols among various authors, the results to be obtained by serial electrophysiologic testing, and finally discusses the question--not yet resolved--whether an improvement of outcome can thereby be achieved.
20世纪70年代，韦伦斯（Wellens）和约瑟夫森（Josephson）开展的开创性电生理研究表明，在大多数经历过持续性室性心动过速发作且存活下来的患者中，心律失常可在导管实验室通过程控电刺激诱发和终止。后来的研究表明，这种方法也可应用于因室颤导致心脏骤停且与急性心肌梗死无关而存活下来的患者。因此，可推荐进行系列电生理检查，以评估抗心律失常药物的疗效，为这些患者的长期治疗提供指导。本报告重点关注该方法的一些方面，如目前推荐的适应证、不同作者电生理方案的差异、系列电生理检查可获得的结果，最后讨论一个尚未解决的问题，即能否借此改善治疗结果。
